Communication with primary care providers Within 24 hours after randomization, the principal investigator called the infants' primary care providers to inform them about the study design and that the parents have consented to participate in the study. In the case of infants randomized to community-based care, the primary care provider was given the choice of making the decisions about changes in medical care independently or jointly with the nurse specialist. A copy of a protocol for management of infants with CLD, developed by the study team was mailed to each primary care provider. After each clinic visit (for the center-based group) the primary care provider received a letter describing findings, impressions, and recommendations. Contacts with the primary care physicians of infants randomized to community-based care occurred whenever the nurse specialist believed that a change in care was indicated.